This program is directed toward understanding the alterations in energy exchange produced by acute injury and/or sepsis in man. Changes in the kinetics of foodstuffs are measured by use of C14 glucose and N15 alanine; extending the information from metabolic balance studies of nitrogen and calories utilizing indirect calorimetry. Associated changes in minute ventilation are correlated with CO2 production while cardiac output is related to arterial O2 content and O2 consumption. Regional catherization studies are being performed to compare the blood flow, oxygen consumption and flux of glucose and amino acids across the forearm versus the liver. Acute surgical conditions with resting hypermetabolism are being studied to determine the primary factors stimulating tissue oxidation and whether increased heat production can be caused or is entirely a result of other oxidative stimuli.